KrysE’s Kuumba Custom Order Request
Premium Handcrafted Accessories & Professional Mobile Notary Services
✨ Step 1: Choose Your Project Path:
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🎨 Shop Handcrafted & Custom Accessories
📜 Book a Evening/Weekend Mobile Notary Public Visit (York, PA)
Primary Contact Name
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First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Customer Type
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Individual
Department
Organization or School Name
If you are ordering for a department, please complete the department details below.
Department Name
Purchase Order Number
Select Your Document Type
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Please Select
Private Vehicle Title Sign-Off (Seller Side)
Durable Power of Attorney / Last Will
Healthcare Directive / Bedside Medical Signing
General Affidavit / Bill of Sale / Legal Statement
How many signatures require a notary stamp?
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Please Select
1
2
3
4
5+
Note: Under PA state law, the mandatory fee is a flat $5.00 per signature seal.
Select Your Mobile Travel & Convenience Zone
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Zone 1: York Metro Limits —Downtown, East, West, or North York City Limits (+$25.00 Travel Fee)
Zone 2: Dallastown, Red Lion, Dover, or Wrightsville Loops (+$40.00 Travel Fee)
Zone 3: Zone 3: Hanover Extended Trailing (+$60.00 Travel Fee)
🏥 Compassionate Medical Bedside Bundle (Regional Facilities) (+$105.00 Flat Fee)
Exact Meeting Address or Facility Name
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Include room numbers, hospital floors, or specific public landmarks (e.g., bank parking lot).
Preferred Payment Method for On-Site Fees
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Cash (Exact change required at arrival)
Zelle / Cash App (Processed live at execution)
Credit or Debit Card (Mobile Reader Surcharge Applies)
Appointment
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Select Your Appt Shift
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Saturday & Sunday Mid-Day Shift Loop
Premium Weekday or Late-Night Shift Surcharge
Time Surcharge Value
Mandatory Legal Compliance Agreement
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I confirm that all signing parties will present a physical, unexpired, government-issued photo ID bearing a signature at the time of appointment (Photos/photocopies are strictly illegal in PA). I also understand that documents must remain completely blank and will only be signed live in the direct presence of the notary.
Upload a Photo of Your Document's Notary Signature Page (Optional)
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This helps me verify the exact number of required state stamp seals ahead of time. Please ensure pages are kept entirely un-signed until we meet.
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Calculated Travel Fee
State Stamp Fee Total
🎨 Step 2: Enter Your Design Style Number
Look at our design catalog on our website/social feeds and enter the specific design number or style theme you want us to use (e.g., Design #14, Floral Nurse Theme, Glitter Terracotta).
📿 Step 3: Select Your Baseline Accessory Structure
Custom Badge Reels - $0.00
Custom Beaded Keychain - $0.00
Adhesive Wall Hook Base + Topper - $6.00
Strong Magnet Base + Topper - $8.00
Car Freshener Vent Clip Base + Topper - $10.00
Plain/Ombre/Focal Beaded Pen - $10.00
Standard Silicone Popsocket Phone Base + Topper - $12.00
Premium Magnetic Popsocket Phone Base + Topper - $15.00
Custom Badge Buddy (Includes Premium Custom Wrap) - $18.00
3D Luxury/Bling Writing Pen - $20.00
🔑 Step 3A: Select Your Keychain Base Style
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Standard Beaded Charm Keychain (Short/Traditional Single Charm) — $12.00
Deluxe Character/Theme Keychain (Double Accent Charms) — $15.00
✨ Step 3B: Choose Your Hardware & Styling Upgrades (Optional)
Add a Heavy Duty Carabiner Clip (Masculine / Utility Upgrade) — +$3.50
Add a Premium Plush Pom-Pom — +$5.00
Add a Premium Plush Pom-Pom (With Leather Bow) — +$7.50
🛠️ Step 3C: Choose Your Topper Hardware Base Style for Badge Reels
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Topper ONLY (Includes Velcro Backing - Fits Your Existing Badge Reel Bases) - $8.00
Standard Belt Slide Clip (Permnanet Glue-On) - $15.00
Standard Alligator Swivel Clip (Permnanet Glue-On) - $15.00
Interchangeable Belt Slide System (Base + Topper) - $16.50
Interchangeable Alligator Swivel System (Base + Topper) - $16.50
Quantity
*
✨ Step 5: Select Your Premium Cosmetic Upgrades (Optional)
Add an Aesthetic Dangle Charm — +$1.50
Add a Beaded Bar & Coordinating Beads — +$6.00
Upgrade to a Custom "Interchangeable" Deluxe (Includes Charm + Beaded Bar) — +$5.50
Preferred Payment Method for your 50% deposit:
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PayPal / Credit Card (Guest Checkout)
Zelle
Cash App
Cash (Balance at pickup only)
Other
🚚 Step 6: Choose Your Delivery Method
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Local Pickup / Meet-up Loop (Downtown York, PA) — FREE
Healthcare/Downtown Employee Convenience Delivery (Apple Hill, UPMC, WIC, Downtown Banks/Medical) - $1.99
Mobile Courier Delivery Fee (Fixed 25-Mile Radius Across York Area) - $3.99
Standard Insured Shipping (~$4.75) — Based on weight/destination
Priority Express Rush Shipping — $15.00
Shipping Weight Surcharge
Please Select
badge
keychain
badge buddy
pens
3d/bling pens
magnets
wall hook
car freshner
silicone popsocket
magnet popsocket
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
✨ Custom Design Instructions & Variations
📌 Special Sourcing Note: Looking for a highly specific character or theme not shown in our galleries? Type your request above! (Note: Sourcing custom, out-of-stock flatback materials will add a flat $2.00 material upcharge to your final invoice balance).
Upload Inspiration Photos Here
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Calculated Accessory Subtotal
Are you tax-exempt?
Yes
No
Tax-Exempt ID Upload
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Approving Manager Signature
Your Estimated On-Site Invoice Total:
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